|Publication number||US5094241 A|
|Application number||US 07/467,242|
|Publication date||Mar 10, 1992|
|Filing date||Jan 19, 1990|
|Priority date||Nov 10, 1987|
|Also published as||CA1317036C, CA1334035C, DE3838011A1, DE3838011C2, US4945914, US4991579, US5016639, US5097839, US5119817, US5178164, US5211164, US5397329|
|Publication number||07467242, 467242, US 5094241 A, US 5094241A, US-A-5094241, US5094241 A, US5094241A|
|Inventors||George S. Allen|
|Original Assignee||Allen George S|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (10), Referenced by (325), Classifications (18), Legal Events (7)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This is a division of application Ser. No. 119,353 filed 11/10/87, now U.S. Pat. No. 4,991,579.
Diagnostic techniques that allow the practicing clinician to obtain high fidelity views of the anatomical structure of a human body have proved helpful to both the patient and the doctor. Imaging systems providing cross-sectional views such as computed tomographic (CT) x-ray imagers or nuclear magnetic resonance (NMR) machines have provided the ability to improve visualization of the anatomical structure of the human body without surgery or other invasive techniques. The patient can be subjected to scanning techniques of such imaging systems, and the patient's anatomical structure can be reproduced in a form for evaluation by a trained doctor.
The doctor sufficiently experienced in these techniques can evaluate the images of the patient's anatomy and determine if there are any abnormalities present. An abnormality in the form of a tumor appears on the image as a shape that has a discernable contrast with the surrounding area. The difference in contrast is due ro rhe tumor having different imaging properties than the surrounding body tissue. Moreover, the contrasting shape that represents the tumor appears at a location on the image where such a shape would not normally appear with regard to a similar image of a healthy person.
Once a tumor has been identified, several methods of treatment are utilized to remove or destroy the tumor including chemotherapy, radiation therapy and surgery. When chemotherapy is chosen drugs are introduced into the patient's body to destroy the tumor. During the course of treatment, imagers are commonly used to follow the progress of treatment by subjecting the patient to periodic scans and comparing the images taken over the course of the treatment to ascertain any changes in the tumor configurations.
In radiation therapy, the images of the tumor generated by the imager are used by a radiologist to adjust the irradiating device and to direct radiation solely at the tumor while minimizing or eliminating adverse effects to surrounding healthy tissue. During the course of the radiation treatment, the imaging system is also used to follow the progress of the patient in the same manner described above with respect to chemotherapy.
When surgery is used to remove a tumor, the images of the tumor in the patient can guide the surgeon during the operation. By reviewing the images prior to surgery, the surgeon can decide the best strategy for reaching and excising the tumor. After surgery has been performed, further scanning is utilized to evaluate the success of the surgery and the subsequent progress of the patient.
A problem associated with the scanning techniques mentioned above is the inability to select and compare accurately the cross section of the same anatomical area in images that have been obtained by imagers at different times or by images obtained essentially at the same time using different image modalities, e.g., CT and MRI. The inaccuracy in image comparison can be better appreciated from an explanation of the scanning techniques and how the imaging systems generate the images within a crosssectional "slice" of the patient's anatomy. A slice depicts elemental volumes within the cross-section of the patient's anatomy that is exposed or excited by a radiation beam or a magnetic field and the information is recorded on a film or other tangible medium. Since the images are created from slices defined by the relative position of the patient with respect to the imager, a change of the orientation of image slices the patient results in different elemental volumes being introduced into the slice. Thus, for comparison purposes two sets of approximately the same anatomical mass taken at different times, do not provide comparable information that can be accurately used to determine the changes that occurred between two image slices in the sets. since it is unknown to what extent the two individual image slices selected from the respective sets depict identical views.
The adverse effects on the medical practice of such errors is exemplified by diagnostic techniques utilized by the surgeon or others in diagnosing a tumor within a patient. If a patient has a tumor, its size density and location can be determined with the help of images generated by a scanning device. For the clinician to make an assessment of the patient's treatment, two scanning examinations are required. The patient is subjected to an initial scan that generates a number of slices through the portion of the anatomy, for instance the brain, to be diagnosed. During scanning, the patient is held in a substantially fixed position with respect to the imager. Each slice of a particular scan is taken at a predetermined distance from the previous slice and parallel thereto. Using the images of the slices, the doctor can evaluate the tumor. If, however, the doctor wants to assess changes in the configuration of the tumor over a given period of time, a second or "follow-up" scan has to be taken.
The scanning procedure is repeated, but since the patient may be in a position different from that in the original scan, comparison of the scans is hampered. Slices obtained at the follow-up examination may be inadvertently taken at an angle when compared to the original slices. Accordingly the image created may depict a larger volume than that which was actually depicted before. Conseouently, the surgeon may get a false impression of the size of the tumor when comparing scans taken at different periods. Because of this, slice-by-slice comparison cannot be performed satisfactorily.
Similarly for certain surgical techniques it is desirable to have accurate and reliable periodic scans of identical segments of the tumor within the cranial cavity. If the scans before and after surgery are inaccurate, the doctor may not get the correct picture of the result of surgery. These same inaccuracies apply to other treatments such as chemotherapy discussed above.
Additionally, with regard to imaging systems and the integral part they play in surgical and other tumor treatment procedures, there is a dearth of methods currently existing that allow a determination of a desired location within the body at a given time. For example, U.S. Pat. No. 4,583,538 to Onik, et. al. discloses a localization device that is placed on a patient's skin which can be identified in a slice of a CT scan. A reference point is chosen from a position on the device which exactly correlates to a point on the CT scan. Measurements of the localization device on the CT scan is then correlated to the device on the patient.
Exterior devices have been utilized in an attempt to solve some of these problems with accuracy such as that shown in U.S. Pat. No. 4,341,220 to Perry which discloses a frame that fits over the skull of a patient. The frame has three plates, each defining a plurality of slots on three of four sides. The slots are of varying lengths and are sequentially ordered with respect to length. Frame coordinates defined and found on the frame correspond to the varying heights of the slots. When slices of the skull and brain are taken by an imaging device, the plane formed by the slice intersects the three plates. The number of full slots in the slice are counted with respect to each plate to determine the coordinate of a target site with the brain. Accordingly, only one CT scan is needed to pinpoint the coordinates of the target.
Other attempts have included the use of catheters for insertion into the anatomy. For example, U.S. Pat. No. 4,572,198 to Codington discloses a catheter with a coil winding in its tip to excite or weaken the magnetic field. The weak magnetic field is detectable by an NMR device thus pinpointing the location of the catheter tip with respect to the NMR device.
Applicant's invention largely overcomes many of the deficiencies noted above with regard to imagers used heretofore. The invention relates to a method and apparatus for insuring that scans taken at different times produce images substantially identical to those of previous scans even if they are from different image modalities at different times. This insures that a more accurate assessment of any changes in anatomy is obtained. As a result, the doctor can be more certain as to the size, location and density of the tumor, or a section thereof, that is located in the cranial cavity.
This ability will enhance the use of surgical techniques in removing or otherwise eliminating the tumor in particular by those noninvasive techniques such as laser technology. By having the ability to define accurately the tumor location and size, laser beams can be focused directly on the tumor. Intermittently, as part of surgical techniques, scans can be made to determine if the tumor has moved or substantially changed in size as a result of the surgery. The laser or other surgical instrument can be adjusted accordingly. Because of the accuracy of the imaging techniques produced by the invention, the doctor can be confident that the amount of healthy tissue destroyed during surgery is minimized.
A method adopted by the invention disclosed herein utilizes fiducial implants or implants to define a plane which cooperates with the imager, or other computer, and particularly the data processing capabilities of the imager to insure that subsequent scanning results in slices substantially parallel to those taken during the initial scan. The fiducial implants are implanted beneath the skin into the calvania and are spaced sufficiently from one another to define a plane. The patient with these implants implanted is placed in the scanning device in the conventional manner and scanned to provide the images of consecutive parallel slices of a given thickness along a predetermined path through the cranial cavity.
As the scans are taken, one or more slices will be needed to accommodate part or all of each fiducial implant. The computational features of the imager or other computer will take into account the spatial relationship between any selected plane of a slice and that plane defined by the fiducial implants. Because of this capability, images taken in subsequent scans at different points in time, at different angles can be reconstructed to be substantially identical with the slices taken originally.
Fiducial implants for this purpose are specially configured and made of material that enables their implantation into the skull and the ability to be detected by scanning devices. The fiducial implant as disclosed herein is configured to insure that during implantation it does not have adverse effects on the skull such as cracking or extending through to the cranial cavity. Nor is it sufficiently exposed between the skull and the skin to distort any external features of the anatomy. Furthermore, the fiducial implant is positioned at least on a portion of the skull at the interface of the skin and the bone of the skull to facilitate its imaging by the imager. At least a portion of the implant is symmetrical in cross-section such that slices taken of the cranial cavity for example can be used to locate the center of mass of the implant. This insures accuracy in using the implant image as a reference point to transform the subsequent slices of the follow-up examination into the proper position and orientation.
The above has been a description of certain deficiencies in the prior art and advantages of the invention. Other advantages may be perceived from the detailed description of the preferred embodiment which follows.
A more complete appreciation of the present invention and many of the attendant advantages thereof will be readily obtained, as the same becomes better understood by reference to the following detailed description, when considered in connection with the accompanying drawings, wherein:
FIG. 1 is a side and overhead view of fiducial implants.
FIG. 2 is a side and overhead view of a preferred positioning scheme of fiducial implants in the skull.
FIG. 3 is an offset view of two coordinate systems that have undergone translation with respect to each other.
FIG. 4 is an offset view of two coordinate systems that have undergone rotation with respect to each other.
FIG. 5 and FIGS. 5a, 5b and 5c are offset views of two coordinate systems that have undergone translation and rotation with respect to each other.
FIG. 6 is a flow chart with respect to determining the same point P at two different times in an internal coordinate system to the body.
FIG. 7 is a side view of a preferred embodiment of the present invention.
FIG. 8 is a flow chart with respect to determining the location of a point P in an internal coordinate system with respect to an external coordinate system.
In FIG. 1, there is shown a fiducial implant 10 for the human body that is detectable by an imaging system. The fiducial implant comprises a first portion 12 and a second portion 14. The first portion 12 is configured to be detected by an imaging system (when placed beneath the skin.) The second portion 14 is configured for fixed attachment to the bone beneath the skin without penetrating entirely through the bone and without fracturing the bone as will be described in more detail later. The first portion 12 is of detectable size and comprised of a material for detection by an imaging system and sufficiently small to provide minimal distortion of the skin when placed at an interface between the skin and the bone as will be described in more detail later. First portion 12 also has at least a portion which is spherical and defines a surface for cooperating with a tool for securing the second portion 14 to the bone. Additionally, the placement of three fiducial implants 10 into a portion of anatomy of the human body allows for the recreation of a particular image slice of the portion of the anatomy taken by an imaging system in order to duplicate images taken at the first time period, that is, at the initial examination. This provides a doctor with the ability to accurately follow the progress of treatment on selected slices representing the anatomy of interest.
Moreover, the existence of three fiducial implants 10 allows a target (a tumor for instance) to be identified relative to an external coordinate system. The portion of anatomy with the target may then be operated on, for instance, robotically, or precisely irradiated.
To allow for the accurate comparison of image slices from at least two distinct periods of time, the three fiducial implants 10 are first implanted into a body of a patient at a desired region of interest. The patient is then placed in an imaging system and images of a series of cross-sectional slices are obtained that include, for example, the volume of the tumor which is the primary target of interest. From the imaging data obtained, the three fiducial implants are located and an internal coordinate system is defined with respect to them. If it is so desired, the image data may be further reformatted to show image slices whose direction is different from that obtained originally during the imaging period. Depending on the diagnostic information that these image slices reveal, appropriate decisions with regard to surgery, chemotherapy or radiation therapy on a patient may be made. The imaging data can also be used from several different types of images, such as CT, PET or NMR to obtain the same view of the anatomy but with different qualities stressed.
If it is decided to obtain further imaging data at a later time, then the patient is returned to the imaging system and the procedure for obtaining image data is repeated. The fiducial implants 10 are located with respect to the second imaging session and the same internal coordinate system is defined relative to the implants 10. Once the same internal coordinate system is defined with respect to the second imaging session, the translation and rotation of the internal coordinate system and the images with it is determined with respect to the coordinate system established at the first imaging session. An image slice identified from th first imaging session that is to be used for diagnosis, is recovered from the second imaging session. The two image slices, one from the first image session and one from the second image session, are then compared to determine what changes, if any, have occurred in the anatomy of the patient.
More specifically, a 3-dimensional noncollinear 5 coordinate system requires three distinct noncollinear points to be fully defined. If there are more than three identifiable points, the system is over-determined and three points have to be chosen to define the coordinate system. If there are less than three identifiable distinct points, the system is undetermined and a position relative to the one or two identifiable points will not be defined.
The known location of three distinct points identifies a plane upon which an orthogonal coordinate system can be established. If the three points are fixed in place relative to each other over time in the body, a coordinate system can be established that is also fixed in time. The ability to define a fixed internal coordinate system to the human body over time has important ramifications. A fully defined internal coordinate system that is fixed in place over time with respect to some location in the body permits comparison of subsequent images of the body taken into imaging systems such as CT scans, NMR scans or PET scans, to name a few. More precisely, these comparisons will allow a diagnostician to see what change, if any, has occurred within the body at a predetermined location.
By utilizing a fixed coordinate system relative to the body, the same coordinates can be compared over time. However, the tissue or body material is not necessarily fixed in place relative to a predetermined set of coordinates over time. After the passage of time, the tissue may have shifted, a change not uncommon following surgery. Nevertheless, the ability to compare various properties (depending on the type of images) of the tissue at the same coordinates and at different times is a great advantage for diagnostic purposes.
In principle, the three points (that are necessary) to define a coordinate system can be chosen in a variety of ways. In one embodiment with respect to the brain or head region, the two ears and a tooth, or the two ears and the nose may comprise the three points. Alternatively, an image slice of the skull could provide a set of points from which the three points would be chosen to create the coordinate system for the body. Preferably, three fiducial points that are implanted into the body, and creare high contrast images during scanning, provide the most reliable way to define a coordinate system. Ideally the three points should be in the same approximate area of the body that is under analysis, and also should be identifiable and measureable by different imagery systems, such as CT imagers and NMR imagers.
To create a fully defined coordinate system the detection of three distinct noncollinear fiducial points is required. With respect to creating a fully-defined coordinate system anchored to the human body, the requirement of detection dictates the need that fiducial implants 10 are made of a material that is detectable by a system imaging the human body. The fiducial implant 10 has a first portion 12 that provides means for marking a predetermined position within a body. See FIG. 1. First portion, or marker 12, ideally provides a high contrast in an image compared to the surrounding material. The material marker 12 is made of also provides as little distortion as possible to the image so the appearance of artifacts is kept to a minimum. Marker 12 is also safe for use in the human body and is unobtrusive so no discomfort or self-consciousness is experienced by a wearer.
Marker 12 exhibits symmetrical integrity to facilitate its location by the imaging system. When marker 12 is scanned, the symmetry insures that any plane through the implant provides essentially the same image and the ability to locate its center of mass. The importance of being able to identify the center of the marker 12 lies in the fact that the same exact point can be reproductibly found for use in defining the coordinate system. Error is thus minimized from subsequent recreations of the same coordinate system due to displacement of the coordinate system from a previous alignment. For instance, a sphere is the ideal shape for a marker 12 with respect to symmetrical integrity since the image of any plane of the sphere is always a circle.
By knowing the radius of the spherical object and applying standard algorithms, the center can be determined of the spherical marker 12 from any plane passing through the sphere. The algorithm for determining the center of a sphere may require operator interaction to mark the approximate location of the implant. The center of mass can be determined with successful approximation from the boundary of the circular profile identified through the operator's interaction. For instance, by having information about the density of the fiducial implant's image and assuming it then scan profiles through its image result in bell-shaped distributions, the boundary points of which can be determined therefrom. From the boundary points of the center of mass is computed. This may require additional slices depending on the size of the fiducial implant and its relative position with respect to adjacent slices, particularly when the physical size of the implant exceeds that of the scan slice.
When the centers of mass of the 3 fiducials (10a, 10b, 10c) are determined, then two of them (10a, 10b) define for instance the x-axis vector of the coordinate system and the vector cross product of vectors 10a, 10b and 10a, 10c fully determine the coordinate system as shown in FIG. 5a which is described more fully below.
Marker 12, which is 1 to 10 and preferably 4 millimeters in diameter, can be made of, for example, titanium in the form of a hollow sphere. The hollow of the sphere can be, for example, filled with agarose gel having various desired dopants, the choice of which depends on the imaging system used to best accent or highlight the marker 12. Marker 12 is intimately connected to a second portion 14 of the fiducial implant 10.
The second portion 14 provides means for anchoring the marker 12 into the body. The site of preference for anchoring the marker 12 in the body is bone, since it provides a good material to hold the implant means in place and also because bone stays in a fixed position over time in the body. Anchor 14 is long enough to penetrate into the bone to which it is anchored, and long enough to be firmly embedded without fracturing the bone. Anchor 14 is 1 to 10 and preferably 3 millimeters long. Preferably the anchor 14 should be screwed into the bone, rather than driven with an impact tool to lessen the chance of fracturing the bone. Anchor 14 can also, for example, be made of titanium.
The fiducial implant 10 also has means 16 for receiving force so the anchor 14 can be fixedly secured to the body. Where anchor 14 is a screw preferably an indention 16 in the shape of a polygon recess to receive an allen wrench is located in marker 12. The use of an allen wrench with the associated polygonal recess has more symmetrical integrity than the cross shaped receptor site for a phillips screw driver or a single groove receptor site for a standard screw driver.
The implantation of a fiducial implant 10 having an 14, in this case a screw preferably utilizes a trocar not shown, to penetrate the skin and reach a desired bone site. The trocar is first placed on the skin over the desired anchoring site and a piercing rod therein is forced through the skin. The piercing rod within the trocar is then removed while the trocar is kept in place. A rod with an allen wrench head fitted to the polygonal indentation 16 in the marker 12 of the implant 10 is inserted into the trocar until the screw 14 portion of the implant 10 contacts the anchoring site, for instance bone. Force is then applied to the portion of the rod extending out the trocar until the implant 10 is embedded into the bone. Such a procedure is accomplished under local anesthesia and should only be about 5 minutes in length.
The placement of the three fiducial implants 10 depends on the portion of the anatomy to be evaluated. Essentially, three fiducial implants 10 are placed in three locations such that they are readily identifiable and the locations are fixed with respect to each other over time. If, for example, a study of the skull and brain is to be undertaken, preferably an implant 10A is placed on the midline of the skull 18 just above the hairline, with the other two implants 10B, 10C being placed on the right and left side, respectively, of the midline in a posterior position to the midline implant 10A. See FIGS. 2a and 2b which are a frontal and overhead view of the skull 18, respectively. Another example of an area of interest could be the torso, with one fiducial implant 10 placed on the midline of the sternum and the other two fiducial implants 10 placed laterally thereto on the right and left side, respectively, and in a rib. Or, one fiducial implant 10 can be placed in the spinous process of a vertebra in the midline and the other two fiducial implants placed in the right and left illiac crest, respectively.
Imaging apparatus provides a fixed axis relative to which any other position in space can be located. As a result, the position of the fiducial marker and the coordinate system these markers define can be located relative to the imaging apparatus. The features of the invention permit the location of the markers relative to the imaging apparatus to be recorded for future reference. In subsequent scans, the patient's orientation may change relative to the imaging apparatus. This new orientation can be measured by locating the fiducial markers in relation to the image apparatus and comparing it to the previously recorded location. The comparison technique permits re-orienting images of subsequent scans to a position corresponding to the earlier recorded scan so that image slices are always at generally the same cross-section of the earlier recorded slices.
In actual operation, these positions are defined by the coordinate system and it is the position of these systems that is accomplished by translation and rotation as discussed below.
Once the fiducial implants 10 are in place and a coordinate system defined, subsequent images of the same anatomical volume area can be compared. FIGS. 3, 4 and 5 show blocks that represents a person's head for purposes of illustration. If, for example, images of the brain are being taken, a person's head may be placed below, above or to the side (see FIG. 3), of its location at a previous imaging session. The head might be rotated (see FIG. 4), as compared to its orientation during an earlier imaging session. The head might have undergone rotation and translation as compared to a previous imaging session, see FIG. 5. Regardless of the reason why the head is oriented differenrly, by taking advantage of the fixed fully-defined internal coordinate system in the brain a previous point or slice image of the brain can be obtained from subsequent image information. This is accomplished as shown in FIG. 6, by comparing the location and direction of the plane defined by the three fiducial points at the first examination with the location and direction of the same plane defined by the three fiducial points at the time of the second examination. For simplicity, the origin of the coordinate system is located at a given fiducial point. By measuring the distance in say, the x, y and z directions between the same fiducial point (the origins) at the two different times, the translation of the origin of one coordinate system with respect to the other can be obtained.
Preferably, one can carry out the transformation with respect to rotation from a given cartesian coordinate system to another by means of three successive rotations performed in a specific sequence. Three angles known as the Eulerian angles are then defined. These three Eulerian angles are the three successful angles of rotation that are required to carry out the transformation. The determination of the Eulerian angles is accomplished by first computing the intersection of two planes determined by the fiducial implants, then computing the angle between the fiducial x-axis and the line of intersection (psi), then computing the angle theta; and then computing the angle phi. At this point the three Eulerian angles are determined. For the example given in FIGS. 5a, 5b and 5c the sequence that is required to carry out the transformation is started by rotating the initial systems of axes, xyz, by an angle phi counterclockwise about the z axis as shown in FIG. 5a. (For other transformations, such as those in which a rotation about the Y axis is needed, a different sequence of transformation and rotations can be used). The resultant coordinate system is labelled the xi,eta,zeta axes . In the second stage, intermediate axes, xi,eta,zeta, are rotated about the xi axis counterclockwise by an angle theta to produce another intermediate set, the xi',eta',zeta' axes as shown in FIG. 5b where the third fiducial implant 10c is not shown to simplify understanding. The xi' axis is at the intersection of the xy and xi'eta' planes and is known as the line of nodes. Finally the xi',eta',zeta' axes are rotated counterclockwise by an angle psi about the zeta' axis to produce the desired x'y'z' system of axes as shown in FIG. 5c. The Eulerian angles theta, phi and psi thus completely specify the orientation of the x'y'z' coordinate system relative to the xyz coordinate system and can therefore act as the three needed generalized coordinates.
The elements of the complete transformation A can be obtained by writing a complete transformation matrix as the triple product of the separate rotations, each of which can be written in matrix form. Thus the initial rotation about the z axis can be described by the matrix D:
where xi and x stand for column matrices. Similarly, the transformation from xi,eta, zeta, to xi',eta',zeta' can be described by the matrix C:
and the last rotation to x'y'z' by a matrix B
Thus the matrix of the complete transformation can be written as
which is the product of the successive matrices:
The matrix D can be written as ##EQU1## The matrix C can be written as ##EQU2## The matrix B can be written as ##EQU3## The product matrix A=BCD is then obtained with the help of the above expression. The order of the matrix multiplication depends upon the task identified; in the present case it defines the transformation from the xyz set of axes to the x'y'z' set of axes.
Once the Euler angles are determined, the problem of orientation is solved, at least, in principle. A major simplification of the computation can, however, be achieved if Euler's theorem is implemented.
Euler's theorem on the motion of a rigid body states: that the general displacement of a rigid body with one point fixed is a rotation about some axis.
If the fixed point is taken as the origin of the body set of axes, then the displacement of the rigid body involves no translation of the body set of axes, the only change is the orientation. The theorem then states that the body set of axes can always be obtained as a single rotation of the initial coordinate system. It is characteristic of rotation that it leaves the direction of rotation unaffected by the operation. In other words, any vector lying in the direction of the axis of rotation must have the same components before and after the rotation. A necessary condition is that the magnitude of the vector should be unaffected and is automatically provided by the orthogonality conditions. Thus Euler's theorem can be proven if it is shown that there exits a vector R having the same component before and after the transformation, that is, in both systems. From this it follows, that
The above is an eigenvalue problem that can be written as
where k is constant. The values for which k is soluble are called eigenvalues of the matrix.
The eigenvalue equations may be written
This equation comprises a set of three homogeneous simultaneous equations for the components X,Y,Z of the vector R. Because of this they can never provide the definite values of the three components, only their ratios. Thus the magnitudes of the components remain undetermined. For homogeneous equations the determinant of the above equation has to vanish, and the solution provides the values of k. For the real, orthogonal, matrices the equation must have k=+1.
In general the equation has three roots corresponding to three eigenvectors. The consideration lead to diagonal matrix of k ##EQU4## The matrix equation can then be written
or multiplying from the left by R**(-1)
This equation provides a useful approach to the problem: seek a matrix that transforms A into a diagonal matrix, the elements of which are the desired eigenvalues.
Finally the angle of rotation has to be determined. The direction cosines of the axis of rotation can be obtained by setting k=1 in the eigenvalue equation and solving for the components of R. It can be shown that the trace of the matrix A can be used to determine the angle of rotation w. One has to compute the trace of A, i.e. T, that is,
from which W can be determined.
For the rotations described above to have any meaning, the fiducial implant 10A, or some point, must be at the same place for the two coordinate systems that are being aligned. This requires a translation of the fiducial implant 10A at a location corresponding to one coordinate system into the location of fiducial implant 10A at the other coordinate system. By simply moving the desired coordinate system the linear amounts of x, y and z, with respect to a cartesion coordinate system, the fiducial implant 10A is situated at the same location. For a more complete discussion of the transformation of a cartesian coordinate system into another, see Herbert Goldstein, Classical Mechanics, Addison Wesley, Reading, Mass., 1965, pp. 107-109.
Thus, any point can be obtained with respect to translation and rotation of a given cartesian coordinate system. Since any point can be obtained, any plane can also be obtained, because a plane is comprised of a set of points. For example, if a given point is desired to be looked at over time, then the coordinate of the point is identified with respect to a first time. The translation and rotation information corresponding to the coordinate system at the first time with respect to the second time is then applied to the point at the first time to indicate the coordinates of the identical point in the coordinate system at the second time. The imaging data pertaining to the second time is then searched to find the desired point. This is but one way of many possible ways to obtain the same point in the coordinate system as a function of time.
Similarly, for a plane or slice image, the same procedure is applied to each point of the set of points that make up the slice image. The desired points are then searched for in the image information corresponding to the coordinate system at the second time. Once all the points, with their associated image information are identified, they are reformatted to produce an image slice as close as possible to the desired image slice pertaining to the coordinate system at the first time. Of course, the position of the slice selected by the physician from the initial image slices has to be determined with respect to the fiducial implants. To this end, preferably, the z coordinates or the elevation coordinates of the system have to be introduced. This can be done with respect to any slice in the image set. For instance, the slice containing the first fiducial implant can be chosen.
Ideally, the reformatting step takes image points from image slices of the second time and aligns them together and produces an image slice as similar as possible to the desired image slice of the first time. In practice, however, quite often a point that is necessary for the creation of a reformatted image does not exist because image slices were taken for instance above and below the point. In this case interpolation must be used to estimate the attributes of the missing point so a desired image slice can be prepared. For example, one simple method of interpolation utilizes the two closest known points to the nonexistent desired point. These two known points are also as nearly opposite each other as possible with the desired point therebetween, and averages their image value. For example, if the intensity of the image associated with one point is 6 units on a scale of 1 to 10 units and that of the second point is 4 units, and the two points are essentially equal in distance from the desired point, the desired point is assigned an image intensity value of 5 units. See FIG. 6 which shows the flow chart describing the above overall process.
Interpolation could be avoided if the internal coordinate system is positioned identically at the different times the imaging data is obtained. This could be accomplished by causing the three fiducial implants 10 to be at exactly the same position whenever imaging data is obtained. By having, for instance, an X-ray machine, or following the method discussed below that reveals the location of the fiducial implants in the body with respect to an external coordinate system, and knowing where the implants were positioned at the first time that imaging occurred, the body could be moved to be in the same exact location. One way of moving the body in position is with a table or platform that has 3 dimensional movement. Then, knowing where the coordinate system is in the body with respect to the platform, the platform could be moved up, down, forward, backward and/or rotated so the internal coordinate system is positioned exactly the same way it was the first time imaging data was obtained.
To summarize, and referring to FIG. 6, the procedure consists of the following steps:
1. Locating the fiducial implants in the initial examination image set, and establishing the internal coordinate system;
2. Selection of the slice(s) of interest in the initial set;
3. Determination of the translation distance between the coordinate system determined by the fiducial implants and the selected slice;
4. Localization of the fiducial implants in the follow4. up study;
5. Determination of Eulerian angles in the coordinate system;
6. Determination of the coordina the transformed slice corresponding to the selected slice in the initial system;
7. Determination of the intensity values at each point using interpolation in the axial direction. (Axial direction is defined as the direction of motion of the imager table).
Although there are many different hardware and software embodiments to implement processing of the image data, each can be divided according to its functioning as follows:
(1) hardware that facilitates fast reconstruction of the cross sectional image;
(2) operator-interactive image display;
(3) storage device for images;
(4) hardcopy capability for images.
One embodiment utilizes the existing computer and its peripherals to generate the reformatted images.
Another embodiment utilizes a stand-alone system, in which the images are fed from the respective imager, and then perform the comparative analysis in the stand-alone system. The whole computer part of the imager must be essentially duplicated plus various options for data input supplied, in order to accommodate images of all types. Hardcopy capability is also desirable therein, such as a matrix camera, because permanent records are invaluable to the diagnostician.
Whether a stand-alone system or an existing system is modified for implementation of the above described reformatting, the images are preferably stored as files having two parts: (1) the header that contains the patient's demographic data and information on the examination itself, that is, technical parameters of the exposure or image procedure; and (2) the image matrix. These two parts are preferably stored temporarily (for a couple of days, usually) on magnetic disk drives, and then moved to permanent storage medium, such as magnetic tape or floppy disk. In addition to this file structure a subfile may be added containing the results of the computation (the Euler angles may be added, for instance).
An apparatus 100 carries out the imaging, signal processing and display necessary to provide images of essentially the same coordinates in the human body which can be compared over time, or to provide the location of targets, such as tumors is shown in FIG. 7. Such an apparatus 100 is comprised of an imager 102 that supplies imaging data and is controlled by a programmable computer 104. The imaging data is obtained from a source 106 in the imager 102 that is approximately placed about a patient 107 as is well known in the art. The imaging data experiences signal processing, as described above, and the desired images are displayed on display 108. Additionally, operator interaction can be achieved through an operator control panel 110 and the coordinates of a target can be displayed in the coordinates of the target display 112 for radiation therapy applications.
An application that takes advantage of a fully-defined internal coordinate system of the body relates to radiation therapy. For radiation therapy the location of a radioactive beam of an external coordinate system must be related to the internal coordinate system. See FIG. 5 where the external coordinate system can be considered the unprimed system and the internal system the primed system. The point P can represent the location of a point of a tumor. In this situation the actual distances and locations of the point P in the primed coordinate system, and the location of the origin .s of the primed coordinate system are important. If the point P is known with respect to the internal or primed coordinate system, and the primed coordinate system is known with respect to the external or unprimed coordinate system and the Euler angles of rotation are known, then the location of point P is known with respect to the external coordinate system. For example and referring to FIG. 7, in radiation therapy or surgery knowing where the internal coordinate system A is with respect to an external coordinate system B has many uses. In radiation therapy if the location of a tumor is known with respect to the internal coordinate system and the internal coordinate system is known with respect to an external coordinate system having a radiation source 20, such as an x-ray machine for killing cancer cells, then radiation can be applied only to the tumor provided it can concentrate on the volume of the tumor only. This would remove the guess work of a radiotherapist looking at various images of a tumor in a body and estimating where to aim the radiaticn source so, hopefully, only the tumor is irradiated. The location of a tumor in an internal coordinate system can be identified for instance, by a first imaging session. The data therefrom is stored in a medium that allows its recall when the tumor position is desired to be known and it is not desired to have to retake images of the anatomy.
One way to accomplish the irradiation of a specific location in the body 32, where, for instance, a tumor is located, involves the use of a robot arm 34 whose base 36 can be chosen as the origin (0,0,0) of the external coordinate system B. At the tip 38 of the robot arm 34 is located a sensor 40. The sensor 40 can be a metal detector or an ultrasonic detector or any instrument that can sense the position of a fiducial implant 10 in a body 32. If the fiducial implants 10 are placed in a skull 18 and there is a tumor therein, the sensor 40 in the tip 38 of the robot arm 34 is moved by the arm 34 until it contacts a fiducial implant 10 in the skull 18. The movement of the robot arm 34 is tracked by a computer (not shown) so the position of the sensor 40 relative to the arm's 34 base 36, the origin 0 of the external coordinate B, is known. The means to track the arm is well known and is accomplished by sensors (not shown) in critical locations of the arm 34, detecting rotation or movement of the joints 42 of the arm 74. By supplying this information to a computer along with the information of the fixed lengths of the structure of the robot arm 34, the tip 38 location of the arm 34 is always known. When the tip 38 of the arm 34 rests on the fiducial implant 10 in the skull 18, the location of the internal coordinate system A defined by the fiducial implants 10 is known with respect to the external coordinate system B. Supplying the Euler angles of rotation and the location of the tumor which is known relative to the internal coordinate system A to the computer, provides the ability to determine the location of the tumor in the external coordinate system B. The location of the tumor is known relative to the internal coordinate system through for instance the image data already stored, and the fact that the fiducial implants 10 are also fixed relative to each other once they are in place. The radiation source 20 and where it is aimed is known by the computer relative to the external coordinate system B. The computer, having the information where the tumor is located in the external coordinate system B, can aim the radiation source 20 to precisely irradiate the tumor site in the brain. In general, the location of a point P in the internal coordinate system relative to the external coordinate system is determined when the distance between the origins of the two coordinate systems is known and the Euler angles are known, as described above.
In surgery, the internal coordinate system defined by the three fiducial points can allow, for example, a laser to be followed as it cuts through tissue to a tumor. An imaging system present in the operating theater would be positioned to continually take imaging data that is provided to a computer system which also guides the laser based on the inputted data. As the laser cuts through the tissue, the change in the tissue is apparent through the imaging system and can be followed with respect to the fixed internal coordinate system. When a predetermined position is reached by the laser, or a predetermined portion of tissue has been removed by the laser, the computer controlling the laser and processing the imaging data would discontinue the operation of the laser.
In the operation of the invention, after the fiducial implants are in place in a patient, imaging data is taken at a first time and stored. At distinct intervals in time, for instance about every year thereafter, the patient returns to the location of the imaging system or one similar to it, and undergoes follow-up imaging. The most recently received imaging data is then reformatted, as described above, to obtain high fidelity images of the same cross-sections on the body as attained in the earlier session. The images from the latest session are then compared with the earlier session (if there are many earlier sessions they can all be used for comparison purposes) to determine if there have been any significant changes such as progression or regression of an abnormality, such as a tumor. The imaging data collected from various imaging sessions taken at different time intervals can, of course, be compared many ways such as by reformatting images taken at earlier sessions to show an image slice of interest chosen from the latest session, instead of just comparing image slices of a latest session to those of an earlier session. The purpose of the comparisons, as stated earlier can be multifold: (a) either a simple follow-up of the growth of the tumor, without therapy; or (b) verification of therapeutic treatment, such as radiation or chemotherapy or (c) follow-up of surgical treatment.
In the operation of the invention with regard to radiation therapy, the tumor is first identified in the patient's body. The patient is then positioned in the imaging system such that at least the tumor area can be imaged. The imaging system is used to locate the position of the tumor in the internal coordinate system. The image data can, for instance, then be stored for later use so the tumor position is identified without new images having to be obtained every time radiation therapy is performed. The patient can then be placed before a radiation source, and each time radiation therapy occurs, the information from the imaging session that is stored is supplied to the computer operating the radiation source. The internal coordinate is located with respect to the external coordinate system, for instance by locating one fiducial implant, as described above, with respect to a known position in the external coordinate system. Once the position of the internal coordinate system is known with respect to the external coordinate system, the tumor position is known with respect to the external coordinate system, since the tumor position is already known with respect to the internal coordinate system from the stored imaging information. A radiation source is then aimed, for example by a computer receiving the imaging and position data, at the tumor in the body. With respect to surgery, the procedure that is followed to take advantage of the fiducial implants is similar to the procedure described above for radiation therapy. Once the tumor is located with respect to the internal coordinate system, and the location of the internal coordinate system is known with respect to the external coordinate system, the tumor is located with respect to the external coordinate system. Surgical instruments can then be guided to the tumor by the computer with the imaging system placed in an interactive mode therewith. The imaging data that the imaging system constantly feeds the computer allows the computer to track the progress and the extent of the surgery.
Obviously, numerous (additional) modifications and variations of the present invention are possible in light of the above teachings. It is therefore to be understood that within the scope of the appended claims, the invention may be practiced otherwise than as specifically described herein.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US4036492 *||Nov 10, 1975||Jul 19, 1977||Marvin Glass & Associates||Game apparatus|
|US4465069 *||Jun 20, 1983||Aug 14, 1984||Barbier Jean Y||Cranial insertion of surgical needle utilizing computer-assisted tomography|
|US4608492 *||Apr 9, 1984||Aug 26, 1986||Teledyne Industries, Inc.||Ultraviolet monitor suntan alarm with self test routines|
|US4629451 *||Sep 23, 1985||Dec 16, 1986||Victory Engineering Corp.||Stereotaxic array plug|
|US4674046 *||Jan 18, 1985||Jun 16, 1987||Kabushiki Kaisha Toshiba||Method and apparatus for obtaining three dimensional tomographic images by interpolation of a plurality of projection slice data bind for obtaining projection data for a chosen slice|
|US4710716 *||Sep 20, 1985||Dec 1, 1987||Elscint Ltd.||Slice orientation selection arrangement|
|US4764756 *||Sep 16, 1986||Aug 16, 1988||Sekerheid En Elektronika Laboratoria (Eiendoms) Beperk||Intrusion detector using a vibration-responsive cable|
|US4777598 *||Feb 7, 1986||Oct 11, 1988||Quantel Limited||Image processing systems and methods|
|US4791934 *||Aug 7, 1986||Dec 20, 1988||Picker International, Inc.||Computer tomography assisted stereotactic surgery system and method|
|SU955916A1 *||Title not available|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US5383454 *||Jul 2, 1992||Jan 24, 1995||St. Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US5398684 *||Mar 31, 1992||Mar 21, 1995||Hardy; Tyrone L.||Method and apparatus for video presentation from scanner imaging sources|
|US5464411 *||Nov 2, 1993||Nov 7, 1995||Loma Linda University Medical Center||Vacuum-assisted fixation apparatus|
|US5549616 *||Nov 22, 1994||Aug 27, 1996||Loma Linda University Medical Center||Vacuum-assisted stereotactic fixation system with patient-activated switch|
|US5730745 *||Jun 7, 1995||Mar 24, 1998||Loma Linda University Medical Center||Vacuum-assisted fixation apparatus|
|US5748767 *||Aug 10, 1993||May 5, 1998||Faro Technology, Inc.||Computer-aided surgery apparatus|
|US5787886 *||Apr 10, 1995||Aug 4, 1998||Compass International Incorporated||Magnetic field digitizer for stereotatic surgery|
|US5797924 *||Mar 4, 1996||Aug 25, 1998||Loma Linda University Medical Center||Stereotactic fixation system and calibration phantom|
|US5800352 *||Apr 24, 1996||Sep 1, 1998||Visualization Technology, Inc.||Registration system for use with position tracking and imaging system for use in medical applications|
|US5829444 *||Sep 15, 1994||Nov 3, 1998||Visualization Technology, Inc.||Position tracking and imaging system for use in medical applications|
|US5848967 *||Jun 7, 1995||Dec 15, 1998||Cosman; Eric R.||Optically coupled frameless stereotactic system and method|
|US5851183||Oct 16, 1995||Dec 22, 1998||St. Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US5871445||Sep 7, 1995||Feb 16, 1999||St. Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US5873822 *||Apr 24, 1996||Feb 23, 1999||Visualization Technology, Inc.||Automatic registration system for use with position tracking and imaging system for use in medical applications|
|US5891034||Jun 7, 1995||Apr 6, 1999||St. Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US5967980 *||Dec 17, 1996||Oct 19, 1999||Visualization Technology, Inc.||Position tracking and imaging system for use in medical applications|
|US5987349 *||Apr 18, 1997||Nov 16, 1999||Image Guided Technologies, Inc.||Method for determining the position and orientation of two moveable objects in three-dimensional space|
|US6006126 *||Jun 7, 1995||Dec 21, 1999||Cosman; Eric R.||System and method for stereotactic registration of image scan data|
|US6033415 *||Sep 14, 1998||Mar 7, 2000||Integrated Surgical Systems||System and method for performing image directed robotic orthopaedic procedures without a fiducial reference system|
|US6076008||Feb 3, 1999||Jun 13, 2000||St. Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US6118845 *||Jun 29, 1998||Sep 12, 2000||Surgical Navigation Technologies, Inc.||System and methods for the reduction and elimination of image artifacts in the calibration of X-ray imagers|
|US6146390||Feb 25, 2000||Nov 14, 2000||Sofamor Danek Holdings, Inc.||Apparatus and method for photogrammetric surgical localization|
|US6165181||Oct 15, 1998||Dec 26, 2000||Sofamor Danek Holdings, Inc.||Apparatus and method for photogrammetric surgical localization|
|US6167145||Mar 29, 1996||Dec 26, 2000||Surgical Navigation Technologies, Inc.||Bone navigation system|
|US6167295 *||Jan 3, 1996||Dec 26, 2000||Radionics, Inc.||Optical and computer graphic stereotactic localizer|
|US6175756||Dec 15, 1998||Jan 16, 2001||Visualization Technology Inc.||Position tracking and imaging system for use in medical applications|
|US6226418||Nov 5, 1998||May 1, 2001||Washington University||Rapid convolution based large deformation image matching via landmark and volume imagery|
|US6226548||Sep 4, 1998||May 1, 2001||Surgical Navigation Technologies, Inc.||Percutaneous registration apparatus and method for use in computer-assisted surgical navigation|
|US6235038||Oct 28, 1999||May 22, 2001||Medtronic Surgical Navigation Technologies||System for translation of electromagnetic and optical localization systems|
|US6236875||Oct 5, 1995||May 22, 2001||Surgical Navigation Technologies||Surgical navigation systems including reference and localization frames|
|US6275725||May 5, 1997||Aug 14, 2001||Radionics, Inc.||Stereotactic optical navigation|
|US6282437||May 24, 1999||Aug 28, 2001||Neutar, Llc||Body-mounted sensing system for stereotactic surgery|
|US6296613||Aug 22, 1997||Oct 2, 2001||Synthes (U.S.A.)||3D ultrasound recording device|
|US6298262||May 1, 2001||Oct 2, 2001||Neutar, Llc||Instrument guidance for stereotactic surgery|
|US6322567||Feb 9, 1999||Nov 27, 2001||Integrated Surgical Systems, Inc.||Bone motion tracking system|
|US6341231||Oct 11, 2000||Jan 22, 2002||Visualization Technology, Inc.||Position tracking and imaging system for use in medical applications|
|US6347240||Sep 16, 1997||Feb 12, 2002||St. Louis University||System and method for use in displaying images of a body part|
|US6351661||Dec 14, 1998||Feb 26, 2002||Sherwood Services Ag||Optically coupled frameless stereotactic space probe|
|US6351662||May 24, 1999||Feb 26, 2002||Neutar L.L.C.||Movable arm locator for stereotactic surgery|
|US6370224||Jun 12, 2000||Apr 9, 2002||Sofamor Danek Group, Inc.||System and methods for the reduction and elimination of image artifacts in the calibration of x-ray imagers|
|US6374135||Dec 9, 1999||Apr 16, 2002||Saint Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US6379302||Oct 28, 1999||Apr 30, 2002||Surgical Navigation Technologies Inc.||Navigation information overlay onto ultrasound imagery|
|US6381485||Oct 28, 1999||Apr 30, 2002||Surgical Navigation Technologies, Inc.||Registration of human anatomy integrated for electromagnetic localization|
|US6402762||Mar 13, 2001||Jun 11, 2002||Surgical Navigation Technologies, Inc.||System for translation of electromagnetic and optical localization systems|
|US6405072||Dec 1, 1997||Jun 11, 2002||Sherwood Services Ag||Apparatus and method for determining a location of an anatomical target with reference to a medical apparatus|
|US6408107||Nov 14, 2000||Jun 18, 2002||Michael I. Miller||Rapid convolution based large deformation image matching via landmark and volume imagery|
|US6430434||Dec 9, 1999||Aug 6, 2002||Integrated Surgical Systems, Inc.||Method for determining the location and orientation of a bone for computer-assisted orthopedic procedures using intraoperatively attached markers|
|US6434415||Sep 20, 1999||Aug 13, 2002||St. Louis University||System for use in displaying images of a body part|
|US6442416||Dec 28, 1998||Aug 27, 2002||Image Guided Technologies, Inc.||Determination of the position and orientation of at least one object in space|
|US6445943||Dec 14, 1998||Sep 3, 2002||Visualization Technology, Inc.||Position tracking and imaging system for use in medical applications|
|US6463319||Sep 22, 1998||Oct 8, 2002||St. Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US6470207||Mar 23, 1999||Oct 22, 2002||Surgical Navigation Technologies, Inc.||Navigational guidance via computer-assisted fluoroscopic imaging|
|US6477400||Aug 16, 1999||Nov 5, 2002||Sofamor Danek Holdings, Inc.||Fluoroscopic image guided orthopaedic surgery system with intraoperative registration|
|US6490467||Jun 26, 1998||Dec 3, 2002||Surgical Navigation Technologies, Inc.||Surgical navigation systems including reference and localization frames|
|US6491702||May 29, 2001||Dec 10, 2002||Sofamor Danek Holdings, Inc.||Apparatus and method for photogrammetric surgical localization|
|US6497134||Mar 15, 2000||Dec 24, 2002||Image Guided Technologies, Inc.||Calibration of an instrument|
|US6499488||Oct 28, 1999||Dec 31, 2002||Winchester Development Associates||Surgical sensor|
|US6529765||May 24, 1999||Mar 4, 2003||Neutar L.L.C.||Instrumented and actuated guidance fixture for sterotactic surgery|
|US6546277||May 24, 1999||Apr 8, 2003||Neutar L.L.C.||Instrument guidance system for spinal and other surgery|
|US6560354||Feb 16, 1999||May 6, 2003||University Of Rochester||Apparatus and method for registration of images to physical space using a weighted combination of points and surfaces|
|US6585651||Oct 22, 2001||Jul 1, 2003||Synthes Ag Chur||Method and device for percutaneous determination of points associated with the surface of an organ|
|US6611141||Dec 22, 1999||Aug 26, 2003||Howmedica Leibinger Inc||Hybrid 3-D probe tracked by multiple sensors|
|US6633686||Sep 20, 2000||Oct 14, 2003||Washington University||Method and apparatus for image registration using large deformation diffeomorphisms on a sphere|
|US6662036||Jul 29, 2002||Dec 9, 2003||Sherwood Services Ag||Surgical positioning system|
|US6669635||Jan 14, 2002||Dec 30, 2003||Surgical Navigation Technologies, Inc.||Navigation information overlay onto ultrasound imagery|
|US6675040||Jan 26, 2000||Jan 6, 2004||Sherwood Services Ag||Optical object tracking system|
|US6678545||Jul 16, 2002||Jan 13, 2004||Saint Louis University||System for determining the position in a scan image corresponding to the position of an imaging probe|
|US6687531||Aug 22, 2000||Feb 3, 2004||Ge Medical Systems Global Technology Company, Llc||Position tracking and imaging system for use in medical applications|
|US6694167||Aug 22, 2000||Feb 17, 2004||Ge Medical Systems Global Technology Company, Llc||System for monitoring a position of a medical instrument with respect to a patient's head|
|US6694168||Dec 21, 2000||Feb 17, 2004||Synthes (U.S.A.)||Fiducial matching using fiducial implants|
|US6725080||Mar 1, 2001||Apr 20, 2004||Surgical Navigation Technologies, Inc.||Multiple cannula image guided tool for image guided procedures|
|US6725082||Sep 17, 2001||Apr 20, 2004||Synthes U.S.A.||System and method for ligament graft placement|
|US6738656||Aug 22, 2000||May 18, 2004||Ge Medical Systems Global Technology Company, Llc||Automatic registration system for use with position tracking an imaging system for use in medical applications|
|US6892090||Aug 19, 2002||May 10, 2005||Surgical Navigation Technologies, Inc.||Method and apparatus for virtual endoscopy|
|US6934575||Sep 3, 2002||Aug 23, 2005||Ge Medical Systems Global Technology Company, Llc||Position tracking and imaging system for use in medical applications|
|US6947786||Feb 28, 2002||Sep 20, 2005||Surgical Navigation Technologies, Inc.||Method and apparatus for perspective inversion|
|US6968224||Sep 19, 2003||Nov 22, 2005||Surgical Navigation Technologies, Inc.||Method of detecting organ matter shift in a patient|
|US7007699||Nov 7, 2002||Mar 7, 2006||Surgical Navigation Technologies, Inc.||Surgical sensor|
|US7130676||Aug 29, 2002||Oct 31, 2006||Sofamor Danek Holdings, Inc.||Fluoroscopic image guided orthopaedic surgery system with intraoperative registration|
|US7139601||Apr 12, 2001||Nov 21, 2006||Surgical Navigation Technologies, Inc.||Surgical navigation systems including reference and localization frames|
|US7173265||Aug 12, 2004||Feb 6, 2007||Loma Linda University Medical Center||Modular patient support system|
|US7174202||Dec 17, 2002||Feb 6, 2007||British Telecommunications||Medical navigation apparatus|
|US7199382||Aug 12, 2004||Apr 3, 2007||Loma Linda University Medical Center||Patient alignment system with external measurement and object coordination for radiation therapy system|
|US7237556||Feb 11, 2003||Jul 3, 2007||Smith & Nephew, Inc.||Image-guided fracture reduction|
|US7277594||Nov 5, 2001||Oct 2, 2007||Ao Technology Ag||System and method for preparing an image corrected for the presence of a gravity induced distortion|
|US7280633||Aug 12, 2004||Oct 9, 2007||Loma Linda University Medical Center||Path planning and collision avoidance for movement of instruments in a radiation therapy environment|
|US7383073||Oct 16, 2001||Jun 3, 2008||Z-Kat Inc.||Digital minimally invasive surgery system|
|US7446328||Apr 2, 2007||Nov 4, 2008||Loma Linda University Medical Centre||Patient alignment system with external measurement and object coordination for radiation therapy system|
|US7477926||Mar 30, 2005||Jan 13, 2009||Smith & Nephew, Inc.||Methods and apparatuses for providing a reference array input device|
|US7641660||Mar 8, 2004||Jan 5, 2010||Biomet Manufacturing Corporation||Method, apparatus, and system for image guided bone cutting|
|US7643862||May 15, 2006||Jan 5, 2010||Biomet Manufacturing Corporation||Virtual mouse for use in surgical navigation|
|US7643867||Oct 17, 2003||Jan 5, 2010||Medtronic, Inc.||Fiducial marker devices, tools, and methods|
|US7646899||Feb 4, 2004||Jan 12, 2010||Vanderbilt University||Apparatus and methods of determining marker orientation in fiducial registration|
|US7657300||Mar 21, 2002||Feb 2, 2010||Medtronic Navigation, Inc.||Registration of human anatomy integrated for electromagnetic localization|
|US7660623||Jan 30, 2003||Feb 9, 2010||Medtronic Navigation, Inc.||Six degree of freedom alignment display for medical procedures|
|US7662157||Aug 21, 2003||Feb 16, 2010||Osteomed L.P.||Bone anchor system|
|US7696499||Feb 6, 2007||Apr 13, 2010||Loma Linda University Medical Center||Modular patient support system|
|US7697972||Jul 14, 2003||Apr 13, 2010||Medtronic Navigation, Inc.||Navigation system for cardiac therapies|
|US7720522||Feb 25, 2003||May 18, 2010||Medtronic, Inc.||Fiducial marker devices, tools, and methods|
|US7725162||Oct 2, 2003||May 25, 2010||Howmedica Leibinger Inc.||Surgery system|
|US7751865||Sep 15, 2004||Jul 6, 2010||Medtronic Navigation, Inc.||Method and apparatus for surgical navigation|
|US7763035||Sep 13, 2004||Jul 27, 2010||Medtronic Navigation, Inc.||Image guided spinal surgery guide, system and method for use thereof|
|US7764985||Jul 23, 2004||Jul 27, 2010||Smith & Nephew, Inc.||Surgical navigation system component fault interfaces and related processes|
|US7787934||Jun 4, 2003||Aug 31, 2010||Medtronic, Inc.||Fiducial marker devices, tools, and methods|
|US7794467||Nov 15, 2004||Sep 14, 2010||Smith & Nephew, Inc.||Adjustable surgical cutting systems|
|US7797032||Sep 23, 2002||Sep 14, 2010||Medtronic Navigation, Inc.||Method and system for navigating a catheter probe in the presence of field-influencing objects|
|US7818044||Mar 25, 2008||Oct 19, 2010||Medtronic Navigation, Inc.||Method and apparatus for surgical navigation|
|US7831082||Jun 5, 2006||Nov 9, 2010||Medtronic Navigation, Inc.||System and method for image based sensor calibration|
|US7835778||Oct 16, 2003||Nov 16, 2010||Medtronic Navigation, Inc.||Method and apparatus for surgical navigation of a multiple piece construct for implantation|
|US7835784||Sep 21, 2005||Nov 16, 2010||Medtronic Navigation, Inc.||Method and apparatus for positioning a reference frame|
|US7840253||Sep 30, 2005||Nov 23, 2010||Medtronic Navigation, Inc.||Method and apparatus for surgical navigation|
|US7840256||Dec 12, 2005||Nov 23, 2010||Biomet Manufacturing Corporation||Image guided tracking array and method|
|US7853305||May 13, 2005||Dec 14, 2010||Medtronic Navigation, Inc.||Trajectory storage apparatus and method for surgical navigation systems|
|US7862570||Oct 3, 2003||Jan 4, 2011||Smith & Nephew, Inc.||Surgical positioners|
|US7881770||Mar 16, 2004||Feb 1, 2011||Medtronic Navigation, Inc.||Multiple cannula image guided tool for image guided procedures|
|US7925328||Dec 17, 2007||Apr 12, 2011||Medtronic Navigation, Inc.||Method and apparatus for performing stereotactic surgery|
|US7949096||Jun 28, 2010||May 24, 2011||Loma Linda University Medical Center||Path planning and collision avoidance for movement of instruments in a radiation therapy environment|
|US7953471||Jul 27, 2009||May 31, 2011||Medtronic Navigation, Inc.||Method and apparatus for implantation between two vertebral bodies|
|US7971341||Mar 25, 2008||Jul 5, 2011||Medtronic Navigation, Inc.||Method of forming an electromagnetic sensing coil in a medical instrument for a surgical navigation system|
|US7974677||May 28, 2009||Jul 5, 2011||Medtronic Navigation, Inc.||Method and apparatus for preplanning a surgical procedure|
|US7996064||Oct 19, 2009||Aug 9, 2011||Medtronic Navigation, Inc.||System and method for placing and determining an appropriately sized surgical implant|
|US7998062||Jun 19, 2007||Aug 16, 2011||Superdimension, Ltd.||Endoscope structures and techniques for navigating to a target in branched structure|
|US8005571||Jul 3, 2006||Aug 23, 2011||Neuroarm Surgical Ltd.||Microsurgical robot system|
|US8007448||Oct 8, 2004||Aug 30, 2011||Stryker Leibinger Gmbh & Co. Kg.||System and method for performing arthroplasty of a joint and tracking a plumb line plane|
|US8032204||Nov 16, 2009||Oct 4, 2011||Medtronic, Inc.||Fiducial marker devices, tools, and methods|
|US8041459||Feb 6, 2008||Oct 18, 2011||Neuroarm Surgical Ltd.||Methods relating to microsurgical robot system|
|US8046052||Mar 24, 2010||Oct 25, 2011||Medtronic Navigation, Inc.||Navigation system for cardiac therapies|
|US8046053||Dec 19, 2005||Oct 25, 2011||Foley Kevin T||System and method for modifying images of a body part|
|US8057407||Oct 11, 2005||Nov 15, 2011||Medtronic Navigation, Inc.||Surgical sensor|
|US8060185||Oct 5, 2009||Nov 15, 2011||Medtronic Navigation, Inc.||Navigation system for cardiac therapies|
|US8073530||Mar 29, 2010||Dec 6, 2011||Medtronic, Inc.||Fiducial marker devices, tools, and methods|
|US8074662||Jul 31, 2006||Dec 13, 2011||Medtronic Navigation, Inc.||Surgical communication and power system|
|US8093569||Apr 12, 2010||Jan 10, 2012||Loma Linda University Medical Centre||Modular patient support system|
|US8105339||Jul 21, 2010||Jan 31, 2012||Sofamor Danek Holdings, Inc.||Image guided spinal surgery guide system and method for use thereof|
|US8109942||Apr 21, 2005||Feb 7, 2012||Smith & Nephew, Inc.||Computer-aided methods, systems, and apparatuses for shoulder arthroplasty|
|US8112292||Apr 21, 2006||Feb 7, 2012||Medtronic Navigation, Inc.||Method and apparatus for optimizing a therapy|
|US8165658||Sep 26, 2008||Apr 24, 2012||Medtronic, Inc.||Method and apparatus for positioning a guide relative to a base|
|US8165659||Mar 22, 2007||Apr 24, 2012||Garrett Sheffer||Modeling method and apparatus for use in surgical navigation|
|US8170717||Feb 6, 2008||May 1, 2012||Neuroarm Surgical Ltd.||Microsurgical robot system|
|US8175681||Dec 16, 2008||May 8, 2012||Medtronic Navigation Inc.||Combination of electromagnetic and electropotential localization|
|US8177788||Feb 22, 2006||May 15, 2012||Smith & Nephew, Inc.||In-line milling system|
|US8184773||Apr 7, 2011||May 22, 2012||Loma Linda University Medical Center||Path planning and collision avoidance for movement of instruments in a radiation therapy environment|
|US8185184||Mar 21, 2007||May 22, 2012||Medtronic, Inc.||Fiducial marker devices, tools, and methods|
|US8189889||Feb 20, 2009||May 29, 2012||Loma Linda University Medical Center||Systems and methods for characterizing spatial distortion in 3D imaging systems|
|US8200314||Jan 22, 2007||Jun 12, 2012||British Telecommunications Public Limited Company||Surgical navigation|
|US8210899||Nov 20, 2007||Jul 3, 2012||Loma Linda University Medical Center||Device and method for immobilizing patients for breast radiation therapy|
|US8239001||Jul 11, 2005||Aug 7, 2012||Medtronic Navigation, Inc.||Method and apparatus for surgical navigation|
|US8240856 *||Mar 23, 2009||Aug 14, 2012||Hon Hai Precision Industry Co., Ltd.||Compact projector|
|US8269195||Nov 4, 2008||Sep 18, 2012||Loma Linda University Medical Center||Patient alignment system with external measurement and object coordination for radiation therapy system|
|US8271069||Jul 1, 2010||Sep 18, 2012||Medtronic Navigation, Inc.||Method and apparatus for surgical navigation|
|US8290570||Sep 10, 2004||Oct 16, 2012||Stryker Leibinger Gmbh & Co., Kg||System for ad hoc tracking of an object|
|US8290572||Sep 13, 2010||Oct 16, 2012||Medtronic Navigation, Inc.||Method and system for navigating a catheter probe in the presence of field-influencing objects|
|US8320653||Nov 8, 2010||Nov 27, 2012||Medtronic Navigation, Inc.||System and method for image based sensor calibration|
|US8359730||Jul 1, 2011||Jan 29, 2013||Medtronic Navigation, Inc.||Method of forming an electromagnetic sensing coil in a medical instrument|
|US8382765||Aug 6, 2008||Feb 26, 2013||Stryker Leibinger Gmbh & Co. Kg.||Method of and system for planning a surgery|
|US8396598||Nov 22, 2006||Mar 12, 2013||Neuroarm Surgical Ltd.||Microsurgical robot system|
|US8401616||Sep 23, 2011||Mar 19, 2013||Medtronic Navigation, Inc.||Navigation system for cardiac therapies|
|US8418288||Jan 6, 2012||Apr 16, 2013||Loma Linda University Medical Center||Modular patient support system|
|US8452068||Nov 2, 2011||May 28, 2013||Covidien Lp||Hybrid registration method|
|US8467589||Nov 2, 2011||Jun 18, 2013||Covidien Lp||Hybrid registration method|
|US8467851||Nov 15, 2010||Jun 18, 2013||Medtronic Navigation, Inc.||Method and apparatus for positioning a reference frame|
|US8467853||Nov 14, 2011||Jun 18, 2013||Medtronic Navigation, Inc.||Navigation system for cardiac therapies|
|US8473026||Nov 21, 2006||Jun 25, 2013||Ge Medical Systems Global Technology Company||System for monitoring a position of a medical instrument with respect to a patient's body|
|US8473032||Jun 2, 2009||Jun 25, 2013||Superdimension, Ltd.||Feature-based registration method|
|US8491597||Dec 1, 2010||Jul 23, 2013||Smith & Nephew, Inc. (partial interest)||Surgical positioners|
|US8494613||Jul 27, 2010||Jul 23, 2013||Medtronic, Inc.||Combination localization system|
|US8494614||Jul 27, 2010||Jul 23, 2013||Regents Of The University Of Minnesota||Combination localization system|
|US8523630||Jul 2, 2012||Sep 3, 2013||Loma Linda University Medical Center||Device and method for immobilizing patients for breast radiation therapy|
|US8548565||Feb 1, 2010||Oct 1, 2013||Medtronic Navigation, Inc.||Registration of human anatomy integrated for electromagnetic localization|
|US8549732||Jul 1, 2011||Oct 8, 2013||Medtronic Navigation, Inc.||Method of forming an electromagnetic sensing coil in a medical instrument|
|US8569720||Aug 24, 2012||Oct 29, 2013||Loma Linda University Medical Center|
|US8571637||Jan 21, 2009||Oct 29, 2013||Biomet Manufacturing, Llc||Patella tracking method and apparatus for use in surgical navigation|
|US8611984||Apr 6, 2010||Dec 17, 2013||Covidien Lp||Locatable catheter|
|US8617173||Jan 29, 2013||Dec 31, 2013||Stryker Leibinger Gmbh & Co. Kg||System for assessing a fit of a femoral implant|
|US8617174||Jan 29, 2013||Dec 31, 2013||Stryker Leibinger Gmbh & Co. Kg||Method of virtually planning a size and position of a prosthetic implant|
|US8634897||Dec 13, 2010||Jan 21, 2014||Medtronic Navigation, Inc.||Trajectory storage apparatus and method for surgical navigation systems|
|US8644907||Apr 29, 2010||Feb 4, 2014||Medtronic Navigaton, Inc.||Method and apparatus for surgical navigation|
|US8660635||Mar 8, 2007||Feb 25, 2014||Medtronic, Inc.||Method and apparatus for optimizing a computer assisted surgical procedure|
|US8663088||Dec 2, 2009||Mar 4, 2014||Covidien Lp||System of accessories for use with bronchoscopes|
|US8696548||Jun 9, 2011||Apr 15, 2014||Covidien Lp||Endoscope structures and techniques for navigating to a target in branched structure|
|US8696685||Mar 12, 2010||Apr 15, 2014||Covidien Lp||Endoscope structures and techniques for navigating to a target in branched structure|
|US8706185||Nov 15, 2010||Apr 22, 2014||Medtronic Navigation, Inc.||Method and apparatus for surgical navigation of a multiple piece construct for implantation|
|US8731641||May 7, 2012||May 20, 2014||Medtronic Navigation, Inc.||Combination of electromagnetic and electropotential localization|
|US8737707||Apr 13, 2012||May 27, 2014||Robert D. Pearlstein||Systems and methods for characterizing spatial distortion in 3D imaging systems|
|US8764725||Nov 14, 2008||Jul 1, 2014||Covidien Lp||Directional anchoring mechanism, method and applications thereof|
|US8768437||Oct 25, 2006||Jul 1, 2014||Sofamor Danek Holdings, Inc.||Fluoroscopic image guided surgery system with intraoperative registration|
|US8838199||Feb 14, 2005||Sep 16, 2014||Medtronic Navigation, Inc.||Method and apparatus for virtual digital subtraction angiography|
|US8845655||Aug 16, 2010||Sep 30, 2014||Medtronic Navigation, Inc.||Instrument guide system|
|US8905920||Sep 19, 2008||Dec 9, 2014||Covidien Lp||Bronchoscope adapter and method|
|US8932207||Jul 10, 2009||Jan 13, 2015||Covidien Lp||Integrated multi-functional endoscopic tool|
|US8934961||May 19, 2008||Jan 13, 2015||Biomet Manufacturing, Llc||Trackable diagnostic scope apparatus and methods of use|
|US8981324||Oct 24, 2013||Mar 17, 2015||Loma Linda University Medical Center|
|US9055881||May 1, 2005||Jun 16, 2015||Super Dimension Ltd.||System and method for image-based alignment of an endoscope|
|US9084886||Aug 30, 2013||Jul 21, 2015||Loma Linda University Medical Center||Device and method for immobilizing patients for breast radiation therapy|
|US9089261||Sep 14, 2004||Jul 28, 2015||Covidien Lp||System of accessories for use with bronchoscopes|
|US9113813||Dec 17, 2013||Aug 25, 2015||Covidien Lp||Locatable catheter|
|US9117258||May 20, 2013||Aug 25, 2015||Covidien Lp||Feature-based registration method|
|US9168102||Jan 18, 2006||Oct 27, 2015||Medtronic Navigation, Inc.||Method and apparatus for providing a container to a sterile environment|
|US9196082||May 1, 2014||Nov 24, 2015||Loma Linda University Medical Center||Systems and methods for characterizing spatial distortion in 3D imaging systems|
|US9213107||Mar 10, 2014||Dec 15, 2015||Loma Linda University Medical Center||Ion induced impact ionization detector and uses thereof|
|US9220567||Apr 16, 2007||Dec 29, 2015||Neuroarm Surgical Ltd.||Microsurgical robot system|
|US9271803||May 2, 2013||Mar 1, 2016||Covidien Lp||Hybrid registration method|
|US9504530||Feb 3, 2014||Nov 29, 2016||Medtronic Navigation, Inc.||Method and apparatus for surgical navigation|
|US9545288||Mar 14, 2014||Jan 17, 2017||Think Surgical, Inc.||Systems and devices for a counter balanced surgical robot|
|US9575140||Apr 2, 2009||Feb 21, 2017||Covidien Lp||Magnetic interference detection system and method|
|US9597154||Feb 24, 2014||Mar 21, 2017||Medtronic, Inc.||Method and apparatus for optimizing a computer assisted surgical procedure|
|US9642514||Apr 11, 2014||May 9, 2017||Covidien Lp||Endoscope structures and techniques for navigating to a target in a branched structure|
|US9659374||Jul 24, 2015||May 23, 2017||Covidien Lp||Feature-based registration method|
|US9668639||Jun 8, 2012||Jun 6, 2017||Covidien Lp||Bronchoscope adapter and method|
|US9675424||Jul 22, 2009||Jun 13, 2017||Surgical Navigation Technologies, Inc.||Method for calibrating a navigation system|
|US9757087||Jun 29, 2009||Sep 12, 2017||Medtronic Navigation, Inc.||Method and apparatus for perspective inversion|
|US20020087075 *||Feb 5, 2002||Jul 4, 2002||St. Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US20020109705 *||Nov 5, 2001||Aug 15, 2002||Robert Hofstetter||System and method for preparing an image corrected for the presence of a gravity induced distortion|
|US20020183610 *||Jul 18, 2002||Dec 5, 2002||Saint Louis University And Surgical Navigation Technologies, Inc.||Bone navigation system|
|US20020198451 *||Feb 27, 2002||Dec 26, 2002||Carson Christopher P.||Surgical navigation systems and processes for high tibial osteotomy|
|US20030028091 *||Jun 21, 2002||Feb 6, 2003||Simon David Anthony||Trajectory storage apparatus and method for surgical navigation systems|
|US20030060703 *||Aug 29, 2002||Mar 27, 2003||Barrick Earl Frederick||Fluoroscopic image guided orthopaedic surgery system with intraoperative registration|
|US20030069591 *||Aug 27, 2002||Apr 10, 2003||Carson Christopher Patrick||Computer assisted knee arthroplasty instrumentation, systems, and processes|
|US20030097061 *||Sep 3, 2002||May 22, 2003||Ferre Maurice R.||Position tracking and imaging system for use in medical applications|
|US20030114752 *||Oct 15, 2002||Jun 19, 2003||Jaimie Henderson||Instrument guidance method and system for image guided surgery|
|US20030117135 *||Sep 23, 2002||Jun 26, 2003||Martinelli Michael A.||Method and system for navigating a catheter probe in the presence of field-influencing objects|
|US20030163037 *||Dec 17, 2002||Aug 28, 2003||British Telecommunications Public Limited Company||Surgical navigation|
|US20030163038 *||Feb 28, 2002||Aug 28, 2003||Simon David A.||Method and apparatus for perspective inversion|
|US20030181918 *||Feb 11, 2003||Sep 25, 2003||Crista Smothers||Image-guided fracture reduction|
|US20030187351 *||Mar 28, 2003||Oct 2, 2003||Neutar L.L.C., A Maine Corporation||Instrument guidance system for spinal and other surgery|
|US20030191394 *||Apr 4, 2002||Oct 9, 2003||Simon David A.||Method and apparatus for virtual digital subtraction angiography|
|US20040019265 *||Jul 29, 2002||Jan 29, 2004||Mazzocchi Rudy A.||Fiducial marker devices, tools, and methods|
|US20040024309 *||Apr 30, 2003||Feb 5, 2004||Ferre Maurice R.||System for monitoring the position of a medical instrument with respect to a patient's body|
|US20040030236 *||Jun 4, 2003||Feb 12, 2004||Mazzocchi Rudy A.||Fiducial marker devices, tools, and methods|
|US20040030237 *||Jun 4, 2003||Feb 12, 2004||Lee David M.||Fiducial marker devices and methods|
|US20040043978 *||May 1, 2003||Mar 4, 2004||Wyeth||Tricyclic 6-alkylidene-penems as beta-lactamase inhibitors|
|US20040059217 *||Sep 19, 2003||Mar 25, 2004||Paul Kessman||Method of detecting organ matter shift in a patient|
|US20040116803 *||Jan 9, 2004||Jun 17, 2004||Bradley Jascob||Method and apparatus for electromagnetic navigation of a surgical probe near a metal object|
|US20040152970 *||Jan 30, 2003||Aug 5, 2004||Mark Hunter||Six degree of freedom alignment display for medical procedures|
|US20040152972 *||Apr 25, 2003||Aug 5, 2004||Mark Hunter||Method and apparatus for post-operative tuning of a spinal implant|
|US20040167391 *||Oct 17, 2003||Aug 26, 2004||Solar Matthew S.||Fiducial marker devices, tools, and methods|
|US20040167393 *||Feb 25, 2003||Aug 26, 2004||Solar Matthew S.||Fiducial marker devices, tools, and methods|
|US20040171924 *||Mar 5, 2004||Sep 2, 2004||Mire David A.||Method and apparatus for preplanning a surgical procedure|
|US20050043735 *||Aug 21, 2003||Feb 24, 2005||Osteomed L.P.||Bone anchor system|
|US20050049486 *||Aug 28, 2003||Mar 3, 2005||Urquhart Steven J.||Method and apparatus for performing stereotactic surgery|
|US20050075632 *||Oct 3, 2003||Apr 7, 2005||Russell Thomas A.||Surgical positioners|
|US20050080332 *||Oct 1, 2004||Apr 14, 2005||Shiu Almon S.||Near simultaneous computed tomography image-guided stereotactic radiotherapy|
|US20050085715 *||Oct 17, 2003||Apr 21, 2005||Dukesherer John H.||Method and apparatus for surgical navigation|
|US20050085822 *||Oct 20, 2003||Apr 21, 2005||Thornberry Robert C.||Surgical navigation system component fault interfaces and related processes|
|US20050109855 *||Nov 19, 2004||May 26, 2005||Mccombs Daniel||Methods and apparatuses for providing a navigational array|
|US20050113659 *||Nov 24, 2004||May 26, 2005||Albert Pothier||Device for data input for surgical navigation system|
|US20050113846 *||Oct 13, 2004||May 26, 2005||Carson Christopher P.||Surgical navigation systems and processes for unicompartmental knee arthroplasty|
|US20050119639 *||Jul 23, 2004||Jun 2, 2005||Mccombs Daniel L.||Surgical navigation system component fault interfaces and related processes|
|US20050143651 *||Feb 28, 2005||Jun 30, 2005||Laurent Verard||Method and apparatus for virtual endoscopy|
|US20050149041 *||Nov 15, 2004||Jul 7, 2005||Mcginley Brian J.||Adjustable surgical cutting systems|
|US20050159759 *||Jan 20, 2004||Jul 21, 2005||Mark Harbaugh||Systems and methods for performing minimally invasive incisions|
|US20050197569 *||Jan 24, 2005||Sep 8, 2005||Mccombs Daniel||Methods, systems, and apparatuses for providing patient-mounted surgical navigational sensors|
|US20050203531 *||Mar 8, 2004||Sep 15, 2005||Lakin Ryan C.||Method, apparatus, and system for image guided bone cutting|
|US20050228266 *||Mar 30, 2005||Oct 13, 2005||Mccombs Daniel L||Methods and Apparatuses for Providing a Reference Array Input Device|
|US20050228404 *||Apr 12, 2004||Oct 13, 2005||Dirk Vandevelde||Surgical navigation system component automated imaging navigation and related processes|
|US20050234332 *||Jan 18, 2005||Oct 20, 2005||Murphy Stephen B||Method of computer-assisted ligament balancing and component placement in total knee arthroplasty|
|US20050234465 *||Mar 31, 2005||Oct 20, 2005||Mccombs Daniel L||Guided saw with pins|
|US20050234466 *||Mar 31, 2005||Oct 20, 2005||Jody Stallings||TLS adjustable block|
|US20050234468 *||Apr 4, 2005||Oct 20, 2005||Carson Christopher P||Total knee arthroplasty systems and processes|
|US20050245808 *||Apr 21, 2005||Nov 3, 2005||Carson Christopher P||Computer-aided methods, systems, and apparatuses for shoulder arthroplasty|
|US20050267353 *||Dec 6, 2004||Dec 1, 2005||Joel Marquart||Computer-assisted knee replacement apparatus and method|
|US20050267354 *||Dec 6, 2004||Dec 1, 2005||Joel Marquart||System and method for providing computer assistance with spinal fixation procedures|
|US20050273004 *||Jul 25, 2005||Dec 8, 2005||Simon David A||Method and apparatus for perspective inversion|
|US20050277832 *||Aug 8, 2005||Dec 15, 2005||Foley Kevin T||Percutaneous registration apparatus and method for use in computer-assisted surgical navigation|
|US20050279368 *||Jun 16, 2004||Dec 22, 2005||Mccombs Daniel L||Computer assisted surgery input/output systems and processes|
|US20050281374 *||Aug 12, 2004||Dec 22, 2005||Cheng Chieh C||Path planning and collision avoidance for movement of instruments in a radiation therapy environment|
|US20060002511 *||Aug 12, 2004||Jan 5, 2006||Miller Daniel W||Modular patient support system|
|US20060017022 *||Aug 12, 2004||Jan 26, 2006||Rigney Nickolas S|
|US20060036151 *||Aug 19, 2005||Feb 16, 2006||Ge Medical Systems Global Technology Company||System for monitoring a position of a medical instrument|
|US20060058644 *||Sep 10, 2004||Mar 16, 2006||Harald Hoppe||System, device, and method for AD HOC tracking of an object|
|US20060095047 *||Oct 8, 2004||May 4, 2006||De La Barrera Jose Luis M||System and method for performing arthroplasty of a joint and tracking a plumb line plane|
|US20060122483 *||Dec 19, 2005||Jun 8, 2006||Surgical Navigation Technologies, Inc.||System for use in displaying images of a body part|
|US20060147100 *||Feb 4, 2004||Jul 6, 2006||Vanderbilt University||Apparatus and methods of determining marker orientation in fiducial registration|
|US20060161051 *||Jan 18, 2005||Jul 20, 2006||Lauralan Terrill-Grisoni||Method of computer-assisted ligament balancing and component placement in total knee arthroplasty|
|US20060173293 *||Aug 11, 2005||Aug 3, 2006||Joel Marquart||Method and apparatus for computer assistance with intramedullary nail procedure|
|US20060190011 *||Dec 1, 2005||Aug 24, 2006||Michael Ries||Systems and methods for providing a reference plane for mounting an acetabular cup during a computer-aided surgery|
|US20060200025 *||Dec 1, 2005||Sep 7, 2006||Scott Elliott||Systems, methods, and apparatus for automatic software flow using instrument detection during computer-aided surgery|
|US20060241416 *||Mar 29, 2006||Oct 26, 2006||Joel Marquart||Method and apparatus for computer assistance with intramedullary nail procedure|
|US20070016008 *||Nov 30, 2005||Jan 18, 2007||Ryan Schoenefeld||Selective gesturing input to a surgical navigation system|
|US20070016009 *||Dec 12, 2005||Jan 18, 2007||Lakin Ryan C||Image guided tracking array and method|
|US20070032906 *||Jul 3, 2006||Feb 8, 2007||Sutherland Garnette R||Microsurgical robot system|
|US20070038223 *||Mar 27, 2006||Feb 15, 2007||Joel Marquart||Computer-assisted knee replacement apparatus and method|
|US20070073133 *||Sep 15, 2005||Mar 29, 2007||Schoenefeld Ryan J||Virtual mouse for use in surgical navigation|
|US20070073137 *||May 15, 2006||Mar 29, 2007||Ryan Schoenefeld||Virtual mouse for use in surgical navigation|
|US20070073306 *||Sep 15, 2006||Mar 29, 2007||Ryan Lakin||Cutting block for surgical navigation|
|US20070118055 *||Nov 6, 2006||May 24, 2007||Smith & Nephew, Inc.||Systems and methods for facilitating surgical procedures involving custom medical implants|
|US20070123912 *||Dec 22, 2006||May 31, 2007||Carson Christopher P||Surgical navigation systems and processes for unicompartmental knee arthroplasty|
|US20070164230 *||Apr 2, 2007||Jul 19, 2007||Rigney Nickolas S|
|US20070169782 *||Feb 26, 2007||Jul 26, 2007||Crista Smothers||Image-guided fracture reduction|
|US20070225599 *||Mar 21, 2007||Sep 27, 2007||Image-Guided Neurologics, Inc.||Fiducial marker devices, tools, and methods|
|US20070287910 *||Apr 14, 2005||Dec 13, 2007||Jody Stallings||Quick Disconnect and Repositionable Reference Frame for Computer Assisted Surgery|
|US20080004632 *||Apr 16, 2007||Jan 3, 2008||Sutherland Garnette R||Microsurgical robot system|
|US20080161677 *||Feb 6, 2008||Jul 3, 2008||Garnette Roy Sutherland||Methods Relating to Microsurgical Robot System|
|US20080161830 *||Feb 6, 2008||Jul 3, 2008||Garnette Roy Sutherland||Microsurgical Robot System|
|US20080319491 *||Jun 19, 2008||Dec 25, 2008||Ryan Schoenefeld||Patient-matched surgical component and methods of use|
|US20090043556 *||Aug 6, 2008||Feb 12, 2009||Axelson Stuart L||Method of and system for planning a surgery|
|US20090183740 *||Jan 21, 2009||Jul 23, 2009||Garrett Sheffer||Patella tracking method and apparatus for use in surgical navigation|
|US20090310832 *||Mar 6, 2007||Dec 17, 2009||Han-Joon Kim||Medical Image Processing Method|
|US20100010506 *||Aug 7, 2009||Jan 14, 2010||Murphy Stephen B||Method of Computer-Assisted Ligament Balancing and Component Placement in Total Knee Arthroplasty|
|US20100053566 *||Mar 23, 2009||Mar 4, 2010||Hon Hai Precision Industry Co., Ltd.||Compact projector|
|US20100063630 *||Nov 22, 2006||Mar 11, 2010||Garnette Roy Sutherland||Microsurgical robot system|
|US20100067659 *||Nov 20, 2007||Mar 18, 2010||Loma Linda University Medical Center||Device and method for immobilizing patients for breast radiation therapy|
|US20100192303 *||Apr 12, 2010||Aug 5, 2010||Loma Linda University Medical Center||Modular patient support system|
|US20100217120 *||Mar 29, 2010||Aug 26, 2010||Medtronic, Inc.||Fiducial Marker Devices, Tools, and Methods|
|US20100249581 *||Jun 8, 2010||Sep 30, 2010||Mccombs Daniel L||Surgical Navigation System Component Fault Interfaces and Related Processes|
|US20110054293 *||Jul 27, 2010||Mar 3, 2011||Medtronic, Inc.||Combination Localization System|
|US20110071528 *||Oct 5, 2010||Mar 24, 2011||Carson Christopher P||Systems Using Imaging Data to Facilitate Surgical Procedures|
|US20110071530 *||Oct 5, 2010||Mar 24, 2011||Carson Christopher P||Total knee arthroplasty systems and processes|
|US20110071531 *||Oct 5, 2010||Mar 24, 2011||Carson Christopher P||Systems using imaging data to facilitate surgical procedures|
|US20110092978 *||Nov 12, 2010||Apr 21, 2011||Mccombs Daniel L||Systems and methods for facilitating surgical procedures involving custom medical implants|
|US20110218679 *||Apr 7, 2011||Sep 8, 2011||Loma Linda University Medical Center||Path planning and collision avoidance for movement of instruments in a radiation therapy environment|
|USRE40852||Jan 24, 2000||Jul 14, 2009||Medtronic Navigation, Inc.||Method and system for navigating a catheter probe|
|USRE41066||Jan 14, 1999||Dec 29, 2009||Metronic Navigation, Inc.||Method and system for navigating a catheter probe|
|USRE42194||Jun 12, 2006||Mar 1, 2011||Medtronic Navigation, Inc.||Percutaneous registration apparatus and method for use in computer-assisted surgical navigation|
|USRE42226||Jun 12, 2006||Mar 15, 2011||Medtronic Navigation, Inc.||Percutaneous registration apparatus and method for use in computer-assisted surgical navigation|
|USRE43328||Jan 31, 2002||Apr 24, 2012||Medtronic Navigation, Inc||Image guided awl/tap/screwdriver|
|USRE43750||Jul 13, 2009||Oct 16, 2012||Medtronic Navigation, Inc.||Method for navigating a catheter probe|
|USRE43952||Oct 5, 1990||Jan 29, 2013||Medtronic Navigation, Inc.||Interactive system for local intervention inside a non-homogeneous structure|
|USRE44305||Feb 28, 2011||Jun 18, 2013||Medtronic Navigation, Inc.||Percutaneous registration apparatus and method for use in computer-assisted surgical navigation|
|USRE45509||Jun 17, 2013||May 5, 2015||Medtronic Navigation, Inc.||Percutaneous registration apparatus and method for use in computer-assisted surgical navigation|
|USRE46409||Apr 20, 2015||May 23, 2017||Medtronic Navigation, Inc.||Image guided awl/tap/screwdriver|
|USRE46422||Apr 20, 2015||Jun 6, 2017||Medtronic Navigation, Inc.||Image guided awl/tap/screwdriver|
|WO1996032059A1||Nov 6, 1995||Oct 17, 1996||Compass International Incorporated||Magnetic field digitizer for stereotactic surgery|
|WO2000015134A1||Sep 13, 1999||Mar 23, 2000||Integrated Surgical Systems||System and method for performing image directed robotic orthopedic procedures without a fiducial reference system|
|WO2004070655A3 *||Feb 4, 2004||Dec 2, 2004||J Michael Fitzpatrick||Apparatus and methods of determining marker orientation in fiducial registration|
|U.S. Classification||600/426, 606/130|
|International Classification||A61B19/00, A61B6/03, A61N5/10, G01N23/00, A61B10/00, A61B5/055, A61B6/12|
|Cooperative Classification||A61B90/39, A61B2090/363, A61B2090/3954, A61B90/10, Y10S378/901, A61B6/12, A61N5/1049|
|European Classification||A61B19/20, A61B6/12|
|Nov 9, 1993||CC||Certificate of correction|
|Mar 15, 1994||CC||Certificate of correction|
|Aug 28, 1995||FPAY||Fee payment|
Year of fee payment: 4
|Sep 10, 1999||FPAY||Fee payment|
Year of fee payment: 8
|Sep 8, 2003||FPAY||Fee payment|
Year of fee payment: 12
|Sep 24, 2003||REMI||Maintenance fee reminder mailed|
|Oct 26, 2004||AS||Assignment|
Owner name: MARKER, LLC, TENNESSEE
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:ALLEN, M.D., GEORGE S.;REEL/FRAME:015286/0266
Effective date: 20040916